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Published on: January 23, 2026
Airway Management of Incidental Vallecular Cysts in Adults
Leon Vorobeichik1, Gregory M T Hare, Molly Zirkle
1From the *Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada; †Department of Anesthesia, St. Michael's Hospital, University of Toronto, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada; and ‡Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Abstract:
Vallecular cysts, largely asymptomatic in adults, are typically described only on incidental discovery during laryngoscopy, where they may present a challenge in airway management. The current literature is limited to case reports despite the potential for life-threatening complications. We describe management of such a case complicated by cyst rupture and intensive care unit admission. A literature review of eligible case reports was conducted, demonstrating an association between incidental vallecular cysts and difficult bag-mask ventilation and laryngoscopy with intraoperative otolaryngology consultation and intervention being common. Anesthetic management recommendations are thus presented, highlighting any conflicts with current difficult airway algorithms.
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